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Revue de neuropsychologie

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Memory impairment in posttraumatic stress disorder: behavioural and neuroimaging findings Volume 5, issue 1, Janvier-Février-Mars 2013

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Authors
Inserm, U1077, 14000 Caen, France, Université de Caen - Basse-Normandie, UMR-S1077, 14000 Caen, France, École pratique des hautes études, UMR-S1077, 14000 Caen, France, CHU de Caen, UMR-S1077, 14000 Caen, France, CHU de Caen, service de psychiatrie de l’enfant et de l’adolescent, France, CHGR Rennes-I, service universitaire de psychiatrie de l’enfant et de l’adolescent, 35000 Rennes, France

When an event is perceived as life-threatening or potentially causing serious bodily injury to self or others, an intense feeling of fear, horror or helplessness can be elicited and memory process can be disrupted leading to development of posttraumatic stress disorder (PTSD). This pathology is characterised by three kinds of symptoms: (i) re-experiencing, this is probably the principal PTSD symptom and refers to intrusive memories occurring in flashbacks or/and nightmares so invasive that the PTSD sufferer feels as if he is reliving the sensory and emotional aspects as occurring in the present; (ii) avoidance, the sufferer tries to avoid everything that may remind him of the traumatic event (thoughts, places, people and other reminders of the trauma) and (iii) hyper-arousal, this includes hyper-vigilance, exaggerated startle reaction, sleep disturbances and irritability. The purpose of this article is to review the current state of knowledge on memory disturbances and cerebral abnormalities that are central to the pathology's importance. On one hand, PTSD in adults is well documented, and a concise description of impairment of traumatic event memory has been established, involving both enhanced memory for emotional aspects and decreased memory for contextual information. As for traumatic events, memory for everyday events is also impaired in PTSD with hypermnesia for negative information and lower memorizing of neutral information. Structural and functional abnormalities of brain areas implicated in episodic memory (hippocampus), emotional memory (amygdala) and emotional regulation (medial prefrontal and anterior cingulate cortices) seem involved in memory disturbances observed in PTSD. We will describe the two main theories synthesizing current understanding in adult PTSD. On the other hand, in children, whereas symptoms are well described, the lack of investigations hinders the accurate identification of a particular profile of memory dysfunctions and their cerebral substrates. However, we will review the few findings in this field.